Paecilomyces lilacinus is a ubiquitous saprophytic fungus that rarely causes infections in humans, frequently affecting the eyes and the skin. Cutaneous and subcutaneous infections mainly occur in ... [more ▼]

Paecilomyces lilacinus is a ubiquitous saprophytic fungus that rarely causes infections in humans, frequently affecting the eyes and the skin. Cutaneous and subcutaneous infections mainly occur in immunocompromised hosts but have occasionally been reported in immunocompetent patients. The clinical spectrum is highly heterogeneous and diagnosis is often delayed. A 60-year-old woman with idiopathic chronic necrotizing vasculitis treated since 10 years with a series of immunosuppressive therapies presented since three years various clinical presentations of chronic hyalohyphomycosis caused by P. lilacinus. Diagnosis was only obtained three years after the first clinical signs, following the histologic analysis of the surgical excision of a cutaneous abscess. Treatment with oral voriconazole was successful. This case report illustrates the highly heterogeneous clinical aspects of hyalohyphomycosis by P. lilacinus leading to a delay in diagnosis and treatment, particularly in the immunosuppressed patient. [less ▲]

Objectives: To investigate the epidemiological determinants responsible for the high number of anthropophilic dermatophytes received by the National Reference Center for Mycosis of Liege (NRCL) during the ... [more ▼]

Objectives: To investigate the epidemiological determinants responsible for the high number of anthropophilic dermatophytes received by the National Reference Center for Mycosis of Liege (NRCL) during the year 2012. To perform a genotypic characterization by the Diversilab® system focusing on the two main isolated species, Microsporum audouinii and Trichophyton violaceum. To present a preliminary study preceding the national survey launched in 2013. Methods: A total of 51 strains of M. audouinii (50 clinical + 1 reference (ref.) strains) and 15 strains of T. violaceum (14 clinical + 1 ref. strain) originating from different locations through Belgium were included in the study. The fungal strains were first cultivated on Malt agar, then sub-cultured in Sabouraud liquid medium (Fluka). The grown mycelium was processed for DNA extraction following recommendations of the manufacturer (Ultra Clean® DNA Microbial isolation kit, MoBio laboratories). Genotypic analysis was performed using the DiversiLab® system (BioMérieux) for DNA fingerprinting and analysis. Results: Regarding M. audouinii, four different genotypic groups of strains were separated. Group 1 includes 11 strains and is only found in the Liège surroundings. Group 2 includes only one strain with little differences compared to group 1 and collected from the Liège area. These two groups may be related to each other. Group 3 contains 36 strains and the reference strain. This genotype is distributed in different Belgium locations. The last group, group 4, contains only 3 isolates sharing low similarities in comparison with the 3 other groups. Concerning T. violaceum, 6 different genotypic groups with a mixed geographical distribution were determined. Group 1 includes 8 clinical isolates and the ref. strain. The other five isolates are all different and seem not to be related to each other. Conclusion: The automated typing DiversiLab® system proved to be an easy and efficient method to investigate the molecular epidemiology of dermatophytes infections. Preliminary results of the study show that, through Belgium, several groups of isolates co-exist for M. audouinii and T. violaceum providing evidence of genetic heterogeneity. This variation can be related to acquired mutations due to environmental adaptation. Further investigations are necessary to better understand the impact of this genotypic variation. [less ▲]

ADAMTS2 belongs to the "ADAM metallopeptidase with thrombospondin type I motif" (ADAMTS) family. Its primary function is to process collagen type I, II, III, and V precursors into mature molecules by excising the aminopropeptide. This process allows the correct assembly of collagen molecules into fibrils and fibers, which confers to connective tissues their architectural structure and mechanical resistance. To evaluate the impact of ADAMTS2 on the pathological accumulation of extracellular matrix proteins, mainly type I and III collagens, we evaluated carbon tetrachloride-induced liver fibrosis in ADAMTS2-deficient (TS2(-/-)) and wild-type (WT) mice. A single carbon tetrachloride injection caused a similar acute liver injury in deficient and WT mice. A chronic treatment induced collagen deposition in fibrous septa that were made of thinner and irregular fibers in TS2(-/-) mice. The rate of collagen deposition was slower in TS2(-/-) mice, and at an equivalent degree of fibrosis, the resorption of fibrous septa was slightly faster. Most of the genes involved in the development and reversion of the fibrosis were similarly regulated in TS2(-/-) and NW mice. Conclusion: These data indicate that the extent of fibrosis is reduced in TS2(-/-) mice in comparison with their WT littermates. Inhibiting the maturation of fibrillar collagens may be a beneficial therapeutic approach to interfering with the development of fibrotic lesions. [less ▲]

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates ... [more ▼]

One of the most important complications associated with bone marrow transplantation (BMT) is graft-versus-host reaction (GVHR) altering different organs. The immunosuppressive regimen frequently abates the severity of cutaneous lesions to a peculiar lymphocyto-depleted GVHR (LD-GVHR) with scant recognizable inflammatory cells and almost absence of epidermal injury. The recently revisited histological criteria for cutaneous GVHR are of little help in diagnosing such LD-GVHR. As calprotectin (L1-protein) has been reported to be expressed in several types of stressed epithelia, we assessed the epidermal calprotectin expression during LD-GVHR. Calprotectin expression was studied by immuno-histochemistry using the Mac 287 moAb in 50 cases of LD-GVHR and 40 cases of toxic reactions due to the conditioning regimens or to post-transplant drugs. Calprotectin was evidenced in normal looking keratinocytes of all cutaneous LD-GVHR cases and in the vast majority of cytotoxic drug-induced dermatitis. It is concluded that calprotectin immunoreactivity appears to be a diagnostic clue in LD-GVHR. The epidermal calprotectin expression occurs early in GVHD, irrespective of the histological grading. However, it cannot be used alone to distinguish early LD-GVHR from drug-induced dermatitis. [less ▲]

We studied the fate of dermal dendrocytes in patients treated with psoralens and ultraviolet light by combining immunohistochemistry and computerized image analysis. Factor-XIIIa-positive dermal dendrocytes were found to be altered in these patients. When compared with controls, dermal dendrocytes were often increased in number and had an uneven size and tissue distribution. Their cytoplasm was occasionally fragmented. These changes were more pronounced when early photosclerosis was present. The alterations described probably reflect vascular changes, and may be responsible for immunomodulating actions and disorder of the connective tissue structure induced by ultraviolet light. [less ▲]